If there’s one thing that goes back to the very beginning of this blog (or at least it started in the first year), it’s having a bit of fun with Deepak Chopra. I realize that to some it might seem like shooting the proverbial fish in a barrel. With a rocket launcher. On the other hand, I like to look at it this way. Deepak Chopra has a multimillion dollar alternative medicine and “quantum consciousness” empire milking the credulous to buy attend his lectures, buy his DVDs and books, and even to buy his video games. He’s on television all the time, including appearances on Dr. Oz’s show and on Oprah Winfrey’s show back when she had her regular talk show. I’m just an itty-bitty blogger who reaches a few thousand readers a day at most. While that is definitely quite respectable as far as medical/skeptical bloggers go, compared to Chopra’s reach it’s the proverbial ant compared to Chopra’s media elephant. So, because Chopra has so much influence, I consider it more important than for many other purveyors of woo to critically examine the nonsense that Chopra lays down on such a regular basis and show why it’s nonsense. Indeed, never forget, I was the one who first coined the term “Choprawoo.” More importantly, if there’s anyone who personifies the similarities between alternative medicine and religion, it’s Deepak Chopra, with his “universal consciousness” (i.e., yet another name for God, but all gussied up with quantum quackery).
This time around, Chopra is delving into placebo medicine. Regular readers of this blog should be aware that promoters of “complementary and alternative medicine” (CAM), a.k.a., “integrating quackery with science-based medicine and calling it “integrative medicine,” have latched onto placebo effects the way a wolf latches on to its prey, sometimes going so far as to call it the “powerful placebo.” The reason is quite simple. Even woo-meisters like Chopra have noticed that the more rigorous and large the clinical trial of their favorite CAM modalities, the less distinguishable from placebo effects they become. In other words, the vast majority of CAM is placebo medicine. So what’s a quack to do, when faced with a growing and persuasive body of evidence consistent with the contention that his favorite modalities don’t do anything, that they function primarily as placebo? Well, like Mitt Romney and Paul Ryan on Medicare, they decide that the best defense of an indefensible position is a good offense and embrace the placebo. Instead of arguing that their quackery has any specific healing effects, they claim that it “harnesses the power of placebo” to induce “natural healing” or (one of their favorite terms) “mind-body healing.” So it is that I saw Deepak Chopra try to do the same thing. The difference is that he puts a somewhat different spin on placebo medicine in an article entitled I Will Not Be Pleased – Your Health and the Nocebo Effect. Chopra starts with the usual woo-ful whine about how conventional medicine discounts placebo effects:

For decades the placebo effect has existed basically as a nuisance, so far as the medical profession is concerned. Some people benefit from being given a sugar pill instead of an actual drug. This remarkable result cannot be marketed, however. It doesn’t fall within the ethics of medicine to prescribe fake drugs. Therefore, a doctor in practice, whose training has drummed into him that “real” medicine means drugs and surgery, will shrug off the placebo effect as psychosomatic, or “it’s all in your head.”

This attitude shuts down a fascinating possibility, that a patient’s expectations plays a major role in being well or getting sick.

The placebo effect is real medicine, because it triggers the body’s healing system. One could argue that this is the best medicine, in fact, since: a. drugs do not trigger the healing system and b. the placebo effect has no side effects. Staying well means that the body is taking care of itself – and you – through a feedback loop of chemical messages. Circulating throughout the bloodstream, lymphatic system, and central nervous system, chemical messages are crucial to the healing system, because they keep every cell in communication with every other.

Yes, just as I’ve been discussing so recently, this is nothing more than alternative medicine as The Secret or, as I put it before a while back, viewing placebo effects as nothing more than wish fulfillment, a pure manifestation of The Secret. So far, Chopra’s just using standard alt-med placebo medicine boilerplate. If you think it hard enough, you can heal yourself. Placebo effects are nothing more than The Law of Attraction in action: If you want healing badly enough you’ll get it.

So, perhaps it shouldn’t be too surprising that the negative aspect of the Law of Attraction, the truly vile part of it is that, if you are sick, it means that you’re “attracting” negativity and sickness to yourself. In Chopra’s world, this means the nocebo effect:

Like it or not, every thought, decision, and action influences this feedback loop. The “or not” is important. Unwittingly, we damage the body’s natural state of health with negative input. The fact that this input comes from the brain means that thoughts, moods, and expectations, however intangible, get translated into chemical messages just as surely as molecules of aspirin or glucose. You and I bear the responsibility of sending positive messages to our cells as opposed to negative ones.

See what I mean? A clearer statement of the the Law of Attraction (although Chopra doesn’t call it that) is hard to imagine, with the Law of Attraction being placebo and nocebo effects. If you think happy, healing thoughts, you’ll be healthy. If you don’t, if you think unhappy thoughts, if you have the slightest bit of negativity, the slightest negative mood (no matter how intangible, as Chopra himself says), you’re screwed. Chopra said so. You bear the responsibility for it. Chopra said so, and the result is the negative energy being transmitted to your cells

Or, as he puts it:

The key to the placebo effect is that the patient expects a good outcome, while in the nocebo effect the expectation is of a bad outcome: I will be pleased versus I will not be pleased. Set aside the medical implications. We make judgments about all of our experiences every day, expecting them to turn out well or badly. Does this point to a holistic placebo versus nocebo effect? We’ll explore that possibility in the next post.

Oh, goody. Is that a promise? I’m always happy to know that there will be more blogging material provided to me, that is after I stop laughing. After all, just consider: One of the main points that Chopra makes in this post is his claim that placeboes have no side effects. Yet, the bulk of the article is about nocebo effects. What are nocebo effects but negative side effects from placeboes? He even discusses a case of someone who allegedly became very sick from nocebo effects. Some “perfectly safe” mental healing! I’m telling ya, ya can’t make stuff like this up.

In the meantime while I’m waiting for Chopra to continue his pontifications and bloviations on placebo effects, I suppose I should be grateful for one thing. I suppose I should be grateful that Chopra didn’t invoke quantum physics. In fact, I’m shocked that he didn’t. Think of the possibilities! Quantum placebos. Just remember, you read it here first. I fully expect to see it in Chopra’s next article.

This remarkable result cannot be marketed, however. It doesn’t fall within the ethics of medicine to prescribe fake drugs. Therefore, a doctor in practice, whose training has drummed into him that “real” medicine means drugs and surgery, will shrug off the placebo effect as psychosomatic, or “it’s all in your head.”

I love how he moves the goalposts. Instead of talking about the ethics involved, he sidesteps straight to “medical establishment wants status quo”. As if they were the same thing.

I think I’ve decided that all alt med is about positive thinking and victim blaming. No matter what belief system/method/cause/whatever they overlay it with, it all seems to come down to those two things as a basis. I will, from now on, not be surprised when it’s used as an argument for sCAM.

To be healthy I should strive to have an upbeat, positive mood as close to 100% of the time? This sounds like “If it feels good, DO IT!” – because feeling good is the key to being healthy.

It also makes anyone suffering depression thrice damned:
Once for being depressed
Twice for creating their own depression and any and all ill health
Thrice for having others judge them as being the victim of not a disease, but because they created their own misery.

MMM @0820: It probably means something like this: Chopra had published 55 books at the time of this update to his biography, and he is too lazy to update said biography for a book that doesn’t make the bestseller list. So he makes a statement that, if true, will always remain true. My theory is that he will update (or has updated) that number the next time thereafter he has (had) a bestseller, because he wants his biography to point out that $LATEST_BESTSELLER is one of his books.

the placebo effect has no side effects other than letting the tumor progress from state I to stage IV while you’re feeling good about it, and then lets you die in agony. But that’s your fault, you just didn’t want to be healed.

One could argue that this is the best medicine, in fact, since: a. drugs do not trigger the healing system

Why not? If your argument is that when you take a sugar pill or have a reiki master wave their hands over you your expectations it will work harnesses the “powerful placebo effect” triggering healing, when you take an actual drug (a statin, for example, not only will it have an actual physiologic effect (HMG-CoA reductase pathway inhibition) your expectations it will work should also invoke the powerful placebo’s effect , triggering even greater healing.

Just like Doublemint gum, it’s like two – two – two treatments in one.

Deepak is certainly an interesting case of religion masquerading as science because he has been educated in science and has earned his credentials as a physician ( in endocrinology, IIRC) which he seems to toss aside while presenting water-down Hinduism gussied up with New Age platitudes to impress his followers.

Amongst the woo-meisters, religion and spirituality play a central but sometimes disguised role- they don’t always bring it up until they have already lured you into their camp**. First and foremost they are scientists, researchers, innovators, even *academicians*. Or so they tell us.

Mike Adams has recently inaugerated a website called “Divinity Now” wherein he explores spirituality and cosmic consciousness*** berating soul-less science that leads us to destruction.
Dr Mercola adocates prayer and EFT, which hasn’t a prayer. He is -btw- also a real doctor.
Gary Null is probably the most vocal on the subject: he has a background in (US southern) evangelicalism and is descended from a long line of ‘sensitives’- his mother functioned as a Edgar Cayce-typespiritual advisor and he proclaims his own powers. Often, he can foresee a person’s medical future but of course, he can’t tell them directly so he instead advocates treatment protocols and heals by ‘energy exchange’, attuning their dodgy energy patterns with his excellent one. Aren’t they lucky? He has also done *psi* research while doing his nutrition research: thus he supplies the best of both worlds while counselling people from all walks of life, now numbering in the tens of thousands.

Calling scientists cold, atheistic materials also takes place at sites like AoA and TMR which provide their own take on these issues.

Basically, if you have no data to back up your beliefs you need to make up your own or call upon a higher authority than medical consensus: woo meisters do both. The Lord of the Universe is not subject to question. I always say that if you scratch alt med, you’ll get religion. That’s no secret.

** like Scientologists wait a while until they talk about aliens.
***I like them old ‘Cozmic Blues’ better.

It’s disturbing to think what it’d be like to wholeheartedly buy into the positive thinking trend. It reminds me of that episode of The Twilight Zone where everyone has to keep thinking happy thoughts to appease the omnipotent kid. They have to always think happy and praise everything, lest the slightest negative thought bring on disease, and if they get sick anyway, all of their “friends” start heaping on the scorn for their sinful negative ways.

Bronze Dog is correct: if your theory of disease causation rests purely upon poor diet and lack of exercise, you’ll view people as having brought it on themselves by their habits. I have heard awfully venomous rants about eating hamburgers, pizza, fried foods ,meat, dairy, bakery goods et al and drinking coffee and alcohol that cast aspersion on the wrong-doers themselves.

Often blame is also cast on food processing companies, advertising, the media, the government and doctors who *allow* this tragedy to continue: but like vaccines, you can’t keep blaming the parent for vaccinating- that may turn them off – so others need to be blamed for setting up the crime and profitting by it.

Since Denice brought up fatty foods, there’s one thing I feel like mentioning: “Junk food” and absolutism.

To me, “junk food” is relative. In modern, developed nations, a Triple Baconator is junk food because many of us tend to already have too much fat in our diets for our own good. If, on the other hand, you were a famished medieval peasant who’s been subsisting almost entirely on turnips or something, that Baconator would be a health food, providing proteins, nutrients, and desperately needed fat, which aren’t available in the turnip diet.

Alties, however, seem to see the junk food nature of the Baconator as an absolute, that there is no circumstance where someone can “justify” eating one. It also applies to moderation. If someone’s been sticking to a healthy diet, splurging on infrequent occasions is perfectly acceptable to a skeptic. To an altie, however, it seems a single bite of junk food does unfathomable damage, undoing all the healthy living up to that point. In the event that there’s some altie treatment or diet involved, that single bite provides a convenient way to explain any possible future illness, which returns us to that familiar trend of blaming the victim.

I suspect that the answer to that would be along the lines of “shut up!” and “who let him in?” Followed, perhaps, once they’d thought about it a little, with things like “the side-effects of the drug outweigh any good it achieves” or “you can’t really be thinking positively if you’re resorting to drugs, since it means you don’t trust your body to heal itself”.

No, it doesn’t make sense on examination, but these are arguments of emotion, not reason. And that is the realm of marketing, of course, which makes these arguments more effective than they ought to be on their merits.

“But I quit that! I’ve quit ALL drugs. Well… let me say one thing: I twisted my ankle this morning, and I was in quite a bit of pain… so I went to the doctor, and I asked him to give me some pain pills. And he didn’t want to do it, but I talked him into it. So he gave me some pills — and I shouldn’t have done this, but I took some about an hour before the show tonight, and right now… I am high… as a KITE! [ audience cheers ] I mean, it is unbelievable! And I would NEVER say this to you people, but, in this case: if you EVER get a chance, to take these drugs… DO IT! They’re called… [ he glances from side-to-side cautiously ] Placebos! I mean, I’m thinking that right now I have NO idea where I am at all! It is WILD! Placebo! “

DW: Let’s be clear about this:
1. A gram is better than a damn.
2. Was and will make me ill; I take a gram and only am.
How to wooify # 2? — should be easy.
There was an exchange re terms around woo, etc. I should introduce my favorite: fanciful nonsense. Derived from “Fashionable Nonsense”, the title of a very good book re post-modern abuse of science.

It’s a play on Huxley..
because the woos believe that any and all deviations from their (deviant) purification ritual diets/ exercise regimes are equally, absolutely forbidden ( pesticide-laden) fruit..

but they do believe in homeopathy so perhaps ‘less is more’ wrong
but a bottle of gin is worse than a gram- as it increases the toxin over load
but they do want to have it both ways
therefore d-amned if you do AND if you don’t.
( please don’t try to diagramme that)

Composer — a challenging form of ritual purity, especially when one happens to be a menstruating woman, thus instantly reminding oneself that certain religious are really only written for one gender, with the other only mentioned insofar as pertains to the dominant gender’s interests.

“The key to the placebo effect is that the patient expects a good outcome, while in the nocebo effect the expectation is of a bad outcome: I will be pleased versus I will not be pleased. Set aside the medical implications. We make judgments about all of our experiences every day.”

I could go to a Will Ferrell movie with the highest possible expectations, and it still won’t turn out to be “Citizen Kane”.

Or as I’ve mentioned elsewhere on the subject of medicine, I prefer treatments that work, whether I believe in them or not.

(DW: yes, Huxley. I have his little soma verses memorized.)
In more general comment — placebo effects being a bit of a complication, I believe there are drug testing protocols that employ active placebos. Can we make a distinction between active placebos and total blank placebos? Can the woo-crowd? Is there a point to it? (1993, dude working the line at a Grateful Dead show: get your placebos here, folks.)
There’s something about Chopra “nocebo”passage quoted in Orac’s post that strikes me as vile. Shortest polite word that came to mind.

Ok, why do I feel like a damned piece of used dog chew toy when I don’t take the meds my shrink prescribes me? Drinking gallons of water that got thumped around in a Wal-mart just doesn’t do it for BP II, ADD, and the rest of the alphabet soup. Vitamins are good, but same thing. As for Chopra, the fool probably wants to say ‘almost an infinite number of best-sellers’ but can’t get legal clearance. IIRC, doesn’t he claim to have time-traveled, an infinite unconsciousness, or some other epic tom-woo-lery fail?

Hey – I kind of like the effects of unclean one time a month – you cannot touch food (except that which goes into your own body) – no cooking. You can’t touch other people – no one to take care of. You can’t touch clothing except your own – no laundry.

One week out of four where wow, oops. Sorry, unclean here…

Maybe I’m really lazy or something. A week off with nothing to do every month sounds pretty good to me, even if I do have to take a bath afterwards.

On the post – not surprised at all – what better way to insist your unproven, unlikely methods “work” than insisting the placebo is good for you?

A statue of Samuel Hahnemann, father of homeopathy, was erected by President McKinley in 1900 and he selected the site personally so it could be seen from the White House.

Aside from the fact that the Hahnemann memorial faces west into Scott Circle and is surrounded by a half-wall, so that the statue wouldn’t actually be visible, a mention of the volume History of the Hahnemann Monument in the Journal of Opththalmology, Otology and Laryngology notes that it was constructed “under the auspices of the American Institute of Homoeopathy,” with McKinley merely present at the dedication. A bit of further digging reveals that the TMR story is indeed a complete crock.

Well, over the past few months I ‘ve discovered- by wading through their ignorance-drenched swamp of semi-decayed, stench-emitting intellectual detritus- that these ladies are the essence of crock- there is more crockery there than in a pottery shop.

Did you perchance notice how Ms Poppy chose her ‘nym? And therefore what homeopathic formulae are required to fix the damage? They remind me of pre-teen girls playing a game of “Can you top this?” e.g. autism and intestinal parasites AND said parasites ‘act up’ ( as do their hosts) at the full moon.

The un-funny thing is that other people read their swill and take their advice.

@Mrs Woo: The whole “must not touch something touched by a menstruating woman” thing came up in the book “A Year of Living Biblically”. The author’s wife was so offended by his insistance that he know everything she touched that she sat on every chair in their apartment, forcing him to work from their son’s toy furniture. That rule did not last very long.

LOL @JustaTech. I might have a quirky sense of humor, but I find that very amusing. I believe many parts of that practice probably come from the culture and lifestyle at the time.

I had a pastor back in Colorado who preached living the Law, especially Sabbath observances and dietary restrictions. Once again it is only anecdotal evidence, but he used himself as an example – in his 80s, still running 10 miles or more every week and only needing hearing aids and reading glasses. He insisted there was research demonstrating that those who followed those rules lived longer and healthier lives than the rest of the population, but it was a long time ago and I wouldn’t have any references this many years later even if I did ask for them at that time (he was a pastor, I trusted him).

As someone who has “failed” faith healings (and even been accused of being possessed by one of the healers who failed who then recommended a long period of fasting and prayer and returning to visit them for an exorcism), I really resent the “your thinking made you sick” mantra.

When my mother developed lymphoma in the mid-70s, she did chemo, etc., (since I was 8 years old, her treatment was not described in depth to me, but I heard bits and pieces and was a pretty precocious child), but also did a lot of carrot juicing, celery juicing, etc., because she was assured that the juices alone could “cure” her, and as a mother with two young girls she wanted desperately to survive.

She died of pneumonia early in June just about six months after diagnosis. Many people as I grew up told me about the nurses who raved at her positive attitude, encouragement of others, etc. I’m pretty sure if positive attitude and motivation improved survival, she would still be around.

I think that this might be more understandable if it is viewed as self-protective:
people who believe that a person is totally responsible for ills that befall them/ or failing to heal are trying desperately to hold onto their belief that the world is controllable: if you do the right thing, you’ll be rewarded, if you don’t, you’ll be punished- it’s black-and-white thinking. And it’s *fair*. Life isn’t fair.

If they follow their own method, nothing terrible will ever befall *them*: *you* OBVIOUSLY must have done great wrong to develop a chronic illness. Illness of course, is usually due to a combination of genetics and environment- how you behave is possibly a *part*- never really the whole story ( even for issues like substance abuse).

I often think that the woo-meisters who preach this gospel, for all of their self-proclaimed spirituality, must be terrified of death to a greater degree than is normal.

So Chopra says: ‘This remarkable result cannot be marketed, however. It doesn’t fall within the ethics of medicine to prescribe fake drugs. Therefore, a doctor in practice, whose training has drummed into him that “real” medicine means drugs and surgery, will shrug off the placebo effect as psychosomatic, or “it’s all in your head.””
In 20+ years in medicine, never was I told that it was unethical to give a placebo, and in practice, it was, and I’m sure still is, a useful fallback in any number of situations.
I would rather not list examples because I think of the ones we used as a kind of “trade secret”, but they are used and they sometimes provide beneficial results.
Remember too, that pain and suffering are made worse by anxiety, and the perception that something is being done goes a long way toward decreasing that anxiety.

[…] not for nothing that I have likened alternative medicine to religion or the New Age woo that is The Secret, and these authors simply reinforce that view. First up is radiation oncologist and practitioner of […]

Do not take Placebon™ if you had difficulty getting
dates in high school. Do not operate tunnel boring
machinery or 105mm howitzers after taking Placebon™.
If you are not short or not tall, Placebon™ may not
be right for you. As always, consult your quantum
woomeister before starting a course of Placebon™.

The movie “The Secret” was a good introduction to the basics of the Law of Attraction but it downplayed the hard work that is needed to make things happen. Thinking or affirming things into being is not really how it works. But change is possible if the Law of Attraction is combined with action. It is amazing what can happen with focus and persistence. I continue to be impressed by the power of the universal message of the “New Thought” teachers of the last 100 years, and the relevance of their ideas today. I always go back to William Walker Atkinson’s book “Thought Vibration or the Law of Attraction in the Thought World” when I need an explanation of how the Law of Attraction REALLY works. Check out the new updated gender neutral edition at http://www.hudsonmohawkpress.com

I continue to be impressed by the power of the universal message of the “New Thought” teachers of the last 100 years, and the relevance of their ideas today.

New Thought and its fellow traveler Theosophy were irredeemably addled Hinduistic slop-buckets. Why bother with Atkinson when one can jump right to Napoleon Hill and get the bonus pseudoscientific frosting of “thought waves” that propagate through the medium of Infinite Intelligence?

* The pulsating energy that is generated by your mind-brain is created at a particular frequency.

* If another thinker’s idea is sending pulses of energy out through Infinite Intelligence at the same frequency that your mind-brain is attuned to, your mind-brain receives that idea from Infinite Intelligence.

* When your physical brain intercepts these waves, the ideas and information that the waves are carrying become a part of the store of ideas in your subconscious mind.

And on and globularly blobularly on. I’m sure I’ve mentioned it before, but the most useful thing (aside from some highly amusing artifacts) to emerge from the whole deal is this.